Understanding. Depression. The Road to Feeling Better Helping Yourself. Your Treatment Options A Note for Family Members

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1 TM Understanding Depression The Road to Feeling Better Helping Yourself Your Treatment Options A Note for Family Members

2 Understanding Depression Depression is a biological illness. It affects more than 17 million Americans each year. One out of every seven Americans will suffer from depression at some point. The most important thing to remember about depression is that it can be treated with the help of a health professional. What Is Depression? More Than Just the Blues Depression is more than just the blues. It goes beyond the normal ups and downs in mood we experience as we go through our daily lives. A Serious Medical Illness Depression is an illness. It impacts your mood, mind, body, and behavior. It affects how you eat and sleep, how you feel about yourself, and how you relate to the world around you. Without treatment, symptoms can last for weeks, months, or years. Three Main Types Major Depression This condition usually occurs in episodes (periods lasting 6 to 12 months). Although individual episodes are treatable, most people can expect to have recurrences (new episodes) at some point. Dysthymia This condition is like major depression, but it lasts longer and the symptoms are more mild. People feel bad most of the time but can usually complete everyday tasks. Bipolar Disorder (Manic Depression) This condition causes mood cycles. People cycle between episodes of major depression and episodes of mania (abnormal highs ).

3 Symptoms Symptoms of Depression Loss of interest in things you used to enjoy Feeling sad, blue, or down in the dumps Feeling slowed down and tired, having no energy, or feeling restless and unable to sit still Feeling worthless or guilty Eating more or less than usual and/or gaining or losing weight Problems focusing, thinking, remembering, or making decisions Not being able to sleep or sleeping too much Headaches, aches and pains, stomach problems Loss of sex drive Feeling negative, hopeless, anxious, or worried Increased irritability and anger Thoughts of death or suicide Symptoms of Mania Feeling unusually high and energetic or unusually irritable Needing less sleep Talking a lot or feeling like you can t stop talking, racing thoughts, trouble concentrating Feelings of greatness Acting without thinking Doing dangerous things

4 Who Gets Depressed? Depression can affect anyone. Young or old. Rich or poor. But some people are more at risk than others. Women, for example, are twice as likely as men to be affected by major depression. And, although these illnesses can occur at any age, many people have their first episode between the ages of 25 and 44. Causes of Depression Depression is not something you bring on yourself. And it s not a sign of weakness or failure. Experts think that depression occurs when something triggers a chemical imbalance in the brain. Many different factors can contribute to the onset of a chemical imbalance. These factors include: Having a family history of the disease A stressful life event such as the death of a loved one, a divorce, the breakup of an important relationship, or financial or health problems Long-term use of certain medications, including some blood pressure drugs and some drugs used to treat arthritis and Parkinson s disease Coping with physical illness or chronic pain Having low self-esteem or being overly dependent, self-critical, negative, or easily overwhelmed by stress Alcohol, nicotine, or drug abuse Lack of folic acid or vitamin B12 in the diet The Importance of Treatment Some people are embarrassed to get help for depression. Others believe it will just go away on its own. If you are avoiding treatment, try to remember that depression is like any other serious illness and it needs professional treatment.

5 The Road to Feeling Better HomeCare The road to feeling better can be a difficult one. But if your depression is mild, HomeCare may be enough to help you pull out of it. For more severe depression, HomeCare as well as professional treatment can help. If you are feeling symptoms of depression: Engage in activities that make you feel better. Try exercising, going to a movie, or spending time with loved ones. Set realistic goals. Avoid taking on a lot of responsibility. Break up your workload into small tasks. Don t be hard on yourself if you don t finish every task you set out to do. Do not expect to snap out of your depression. Instead, help yourself as much as you can and do not blame yourself for your feelings. Call your provider if: You start having thoughts about harming yourself in any way. You have had symptoms for 2 or more weeks. Don t wait. The sooner treatment begins, the better the results. Early treatment also increases the chance of preventing serious recurrences.

6 Your Medical Evaluation Making the Diagnosis Before you begin treatment, your provider must diagnose your condition. Meaning, your provider must make sure your symptoms are due to depression and not another health issue. To diagnose your condition, your provider may: Ask about your personal and medical history. Give you a physical exam. Order lab tests. Discussing Treatment Options Once a diagnosis of depression is made, you and your provider can discuss your treatment options. These may include: Medication Psychotherapy (therapy) Medication and therapy combined Other treatments such as light therapy People Who Treat Depression Many people with depression can be treated by a general healthcare provider. But some people need more specialized treatment from a licensed mental health professional. You and your provider will talk about what s best for you. General Providers Medical doctors Physician assistants Nurse practitioners Mental Health Specialists Psychiatrists Psychologists Social workers Psychiatric nurse specialists Mental health counselors

7 Helping Yourself Be patient with yourself. Remember, you have an illness. This illness affects you emotionally, physically, mentally, socially, and spiritually. Recovery takes time. Try to stay active. Try to participate in activities and hobbies you used to enjoy. Take your time and do what you can. Stay connected. Try spending time with other people. Call a friend or drop in on a family member. Even a chat can make you feel more connected. Take care of yourself. Eat a healthy diet and get the right amount of sleep and exercise. While there s no evidence that exercise can reduce depression, it can ease stress and help you relax. Make the most of treatment. Be open and honest with your provider. Follow your provider s instructions. Keep all your appointments even after you start feeling better. Share your treatment plan. Talk to friends and family and tell them what you are going through. Avoid alcohol and recreational drugs. Abuse of alcohol and drugs will slow or prevent recovery. Join a support group. A support group can help you through the recovery process. Group members share their experiences, learn coping skills, and exchange information.

8 Your Treatment Options Therapy Your provider may refer you to a mental health specialist for therapy. This form of treatment can help you identify and manage the factors that affect your depression. Common Types of Therapy Although there are over 200 kinds of therapy, the three discussed below have proven especially helpful in the treatment of depression. Type of Therapy Behavioral therapy Cognitive therapy Interpersonal therapy What It Does Helps change negative styles of behavior Helps change negative styles of thinking Works to improve unhealthy relationships Points to Remember Therapy alone (without medication) is usually not recommended for people with severe depression or for people with bipolar disorder. Although therapy may begin to work right away, it often takes 8 to 10 weeks to show full effect. If you do not feel any better after 6 weeks or if you are not completely well after 12 weeks, talk to your therapist about other treatments. Therapy for depression is usually shortterm (8 to 20 visits). Long-term therapy won t prevent a recurrence, but it may help delay one.

9 Medication Your provider may prescribe medication (an antidepressant) to help correct the chemical imbalance in your brain and improve your symptoms. This can include one type of medication or a combination of medications. Types of Medications There are many medications for depression. Each works a little differently. The type of medication your doctor prescribes will depend on your symptoms and your personal and family histories of depression. Keep in mind that you may have to try more than one drug to find one that s right for you. Questions to Ask Your Provider or Pharmacist When and how often should I take the medication? What are the side effects? Are there any foods I should not eat while taking the medication? Can I have beer, wine, or other alcoholic drinks? Can I take the medication along with the other medications I am taking? What do I do if I forget to take the medication? How much does the medication cost? How long will I need to take the medication? How will I know if the medication is working?

10 A Note About Medication Side Effects You may experience some medication side effects during the first weeks of treatment. Side effects usually improve over time. A small number of people need to stop taking medication due to side effects. Call your provider if you think your medication is causing: Pain, chills, rash, fever, or blurred vision. Side effects that are especially severe or troublesome. Points to Remember Antidepressants are not habit forming. Don t stop taking the medication without talking to your provider even if you start to feel fine. Never make changes in your medication without talking to your provider first. If your medication is working, you should begin to feel better after about six weeks. Medication treatment usually continues for about 4 to 9 months after symptoms have improved. This helps prevent a return of the depressive episode. To prevent a recurrence, your provider may suggest long-term medication treatment. Combining Medication and Therapy Combined treatment includes both therapy and medication. It is often used to treat people who have longer-lasting depression or symptoms between episodes. But it can be used to help anyone with depression. So talk to your provider about whether combination therapy is right for you.

11 A Note for Family Members Do think about joining a support group for family members. Don t exclude your loved one from family matters or discussions. Do learn as much as you can about the illness. Don t pressure the depressed person to recover. Let the person recover at his or her own pace. Do help your loved one follow his or her treatment plan. Don t expect the depressed person to snap out of it. Do try to find ways to cope with your loved one s negative outlook. Don t forget that depression can affect how a person acts. Try not to take it personally. Do look into the possibility of family therapy or counseling. Don t forget to take care of yourself and other family members. Do ask the depressed person to join you in activities he or she used to enjoy. But don t expect too much too soon. Don t ignore comments about suicide. Seek professional advice right away. What About Children? Talking to children about a parent s depression may help them understand and cope. What and how much you say will depend on the child s age and maturity level. Make sure the child knows that the parent s illness is not the child s fault. Think about allowing the child to join family therapy sessions.

12 For More Information The following organizations can provide more information on depression and suggest support groups and providers in your area. American Psychiatric Association American Psychological Association Depression and Bipolar Support Alliance Mental Health America National Alliance on Mental Illness National Institute of Mental Health The information in this guide has been accumulated from current medical literature and is generally accepted by the medical community at this time. However, this information is not meant as a substitute for personal medical advice. If you have worrisome symptoms or conditions, contact a physician immediately , 2003, 2004, 2005, 2006, 2009, 2015 The StayWell Company, LLC This booklet has been customized for Will Rogers Institute. All rights reserved. Made in the USA. 1412

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